As a 40-year-old lesbian I've seen labia of many shapes and sizes, but have yet to see any as large as mine. It has begun to affect my ability to enjoy sex, to the point that I can't climax with a partner. Also, oral sex is my favourite thing, but I no longer enjoy it. I think my vulva is really ugly, and my sexual confidence is low. I have considered labiaplasty, but I'm afraid surgery would deplete sensation.

You may well have large labia compared to other women you have known, but that doesn't mean you are abnormal, or that your labia are unattractive to your partners. You have talked yourself into this very negative obsession (or perhaps you have been influenced by those who stand to profit through encouraging women to feel that their genital shape, size or colour is unattractive or abnormal). But haven't your labia, and indeed every part of your vulva and vagina, served you well in the past and brought you and your partners enormous pleasure? Why would that be different now? Stop focusing on size, and instead pay attention – whether alone or with a partner – to all the wonderful sensations they provide. While making love, focus simply on giving and receiving

pleasure, and if negative thoughts arise, deliberately notice and stop them. Be proud of your uniqueness, and try to see it as a positive attribute; if you do, others will too.

Pamela Stephenson Connolly is a clinical psychologist and psychotherapist who specialises in treating sexual disorders.